Diagnostic utility of fractional exhaled nitric oxide in prolonged and chronic cough according to atopic status

AbstractBackgroundCough-variant asthma (CVA) and cough-predominant asthma (CPA) are the major causes of persistent cough in Japan. The utility of fractional exhaled nitric oxide (FeNO) measurement in the differential diagnosis of persistent cough has been reported, but the influence of atopic status, which is associated with higher FeNO levels, on the diagnostic utility of FeNO has been unknown.MethodsWe retrospectively analyzed 105 non-smoking patients with prolonged and chronic cough that were not treated with corticosteroids and anti-leukotrienes.ResultsCPA was diagnosed in 37 patients, CVA in 40, and non-asthmatic cough (NAC) in 28. FeNO levels were significantly higher in the CPA [35.8 (7.0–317.9) ppb] and CVA [24.9 (3.1–156.0) ppb] groups than in the NAC group [18.2 (6.9–49.0) ppb] (p < 0.01 by Kruskal–Wallis test). The optimal cut-off for distinguishing asthmatic cough (AC; CPA and CVA) from NAC was 29.2 ppb [area under the curve (AUC) 0.74, p < 0.01]. Ninety-one percent of subjects with FeNO levels ≥29.2 ppb had AC. Meanwhile, 40% of AC patients had FeNO levels <29.2 ppb. Stratified cut-off levels were 31.1 ppb (AUC 0.83) in atopic subjects vs. 19.9 ppb (AUC 0.65) in non-atopic subjects (p = 0.03 for AUC).ConclusionsAlthough high FeNO levels suggested the existence of AC, lower FeNO levels had limited diagnostic significance. Atopic status affects the utility of FeNO levels in the differential diagnosis of prolonged and chronic cough

A comprehensive validation of very early rule-out strategies for non-ST-segment elevation myocardial infarction in emergency departments:protocol for a multicentre prospective cohort study

Introduction: Recent advances in troponin sensitivity enabled early and accurate judgement of ruling-out myocardial infarction, especially non-ST elevation myocardial infarction (NSTEMI) in emergency departments (EDs) with development of various prediction-rules and high-sensitive-troponin-based strategies (hs-troponin). Reliance on clinical impression, however, is still common, and it remains unknown which of these strategies is superior. Therefore, our objective in this prospective cohort study is to comprehensively validate the diagnostic accuracy of clinical impression-based strategies, prediction-rules and hs-troponin-based strategies for ruling-out NSTEMIs. Methods and analysis: In total, 1500 consecutive adult patients with symptoms suggestive of acute coronary syndrome will be prospectively recruited from five EDs in two tertiary-level, two secondary-level community hospitals and one university hospital in Japan. The study has begun in July 2018, and recruitment period will be about 1 year. A board-certified emergency physician will complete standardised case report forms, and independently perform a clinical impression-based risk estimation of NSTEMI. Index strategies to be compared will include the clinical impression-based strategy; prediction rules and hs-troponin-based strategies for the following types of troponin (Roche Elecsys hs-troponin T; Abbott ARCHITECT hs-troponin I; Siemens ADVIA Centaur hs-troponin I; Siemens ADVIA Centaur sensitive-troponin I). The reference standard will be the composite of type 1 MI and cardiac death within 30 days after admission to the ED. Outcome measures will be negative predictive value, sensitivity and effectiveness, defined as the proportion of patients categorised as low risk for NSTEMI. We will also evaluate inter-rater reliability of the clinical impression-based risk estimation. Ethics and dissemination: The study is approved by the Ethics Committees of the Kyoto University Graduate School and Faculty of Medicine and of the five hospitals where we will recruit patients. We will disseminate the study results through conference presentations and peer-reviewed journals

DOCK2 is involved in the host genetics and biology of severe COVID-19

「コロナ制圧タスクフォース」COVID-19疾患感受性遺伝子DOCK2の重症化機序を解明 --アジア最大のバイオレポジトリーでCOVID-19の治療標的を発見--. 京都大学プレスリリース. 2022-08-10.Identifying the host genetic factors underlying severe COVID-19 is an emerging challenge. Here we conducted a genome-wide association study (GWAS) involving 2, 393 cases of COVID-19 in a cohort of Japanese individuals collected during the initial waves of the pandemic, with 3, 289 unaffected controls. We identified a variant on chromosome 5 at 5q35 (rs60200309-A), close to the dedicator of cytokinesis 2 gene (DOCK2), which was associated with severe COVID-19 in patients less than 65 years of age. This risk allele was prevalent in East Asian individuals but rare in Europeans, highlighting the value of genome-wide association studies in non-European populations. RNA-sequencing analysis of 473 bulk peripheral blood samples identified decreased expression of DOCK2 associated with the risk allele in these younger patients. DOCK2 expression was suppressed in patients with severe cases of COVID-19. Single-cell RNA-sequencing analysis (n = 61 individuals) identified cell-type-specific downregulation of DOCK2 and a COVID-19-specific decreasing effect of the risk allele on DOCK2 expression in non-classical monocytes. Immunohistochemistry of lung specimens from patients with severe COVID-19 pneumonia showed suppressed DOCK2 expression. Moreover, inhibition of DOCK2 function with CPYPP increased the severity of pneumonia in a Syrian hamster model of SARS-CoV-2 infection, characterized by weight loss, lung oedema, enhanced viral loads, impaired macrophage recruitment and dysregulated type I interferon responses. We conclude that DOCK2 has an important role in the host immune response to SARS-CoV-2 infection and the development of severe COVID-19, and could be further explored as a potential biomarker and/or therapeutic target

The whole blood transcriptional regulation landscape in 465 COVID-19 infected samples from Japan COVID-19 Task Force

「コロナ制圧タスクフォース」COVID-19患者由来の血液細胞における遺伝子発現の網羅的解析 --重症度に応じた遺伝子発現の変化には、ヒトゲノム配列の個人差が影響する--. 京都大学プレスリリース. 2022-08-23.Coronavirus disease 2019 (COVID-19) is a recently-emerged infectious disease that has caused millions of deaths, where comprehensive understanding of disease mechanisms is still unestablished. In particular, studies of gene expression dynamics and regulation landscape in COVID-19 infected individuals are limited. Here, we report on a thorough analysis of whole blood RNA-seq data from 465 genotyped samples from the Japan COVID-19 Task Force, including 359 severe and 106 non-severe COVID-19 cases. We discover 1169 putative causal expression quantitative trait loci (eQTLs) including 34 possible colocalizations with biobank fine-mapping results of hematopoietic traits in a Japanese population, 1549 putative causal splice QTLs (sQTLs; e.g. two independent sQTLs at TOR1AIP1), as well as biologically interpretable trans-eQTL examples (e.g., REST and STING1), all fine-mapped at single variant resolution. We perform differential gene expression analysis to elucidate 198 genes with increased expression in severe COVID-19 cases and enriched for innate immune-related functions. Finally, we evaluate the limited but non-zero effect of COVID-19 phenotype on eQTL discovery, and highlight the presence of COVID-19 severity-interaction eQTLs (ieQTLs; e.g., CLEC4C and MYBL2). Our study provides a comprehensive catalog of whole blood regulatory variants in Japanese, as well as a reference for transcriptional landscapes in response to COVID-19 infection

Lean NOx Capture and Reduction by NH3 via NO+ Intermediates over H-CHA at Room Temperature

The oxidation of NO to NO2 and the subsequent reduction by NH3 via a NO+ intermediate over a proton-type chabazite zeolite (H-CHA) were investigated by the combination of in situ infrared (IR) spectroscopy and density functional theory (DFT) calculations. The in situ IR spectral results indicate that the NO' species formed under a flow of NO + O-2 at 27-250 degrees C are more stable at lower temperatures over both H-CHA and copper-cation-exchanged CHA zeolite (Cu-CHA). The Arrhenius plot (T = 27-120 degrees C) shows a negative apparent activation barrier energy (-11.5 kJ mol(-1)) for the formation of NO+ species under the NO + O(2 )flow over H-CHA. The time course of the IR spectra at 27 degrees C shows that NO is oxidized by O-2 to NO2 and then further converted via N2O4 to NO+ and NO3. The subsequent exposure to NH3 at 27 degrees C reduces the NO species to N-2. DFT calculations revealed that Bronsted acid sites in zeolite pores promote the dissociation of N2O4 intermediates into NO and NO3- species with a low activation barrier (15 kJ mol(-1)). Moreover, the computed activation barrier for the reduction of NO+ species by NH3 was considerably low (6 kJ mol(-1)). The experimental and theoretical results of this study demonstrate the high potential of Cu-free H-CHA zeolites for promoting lean NOx capture to form NO+ species and the subsequent reduction by NH3 at room temperature

Mechanistic insights into the oxidation of copper(i) species during NH3-SCR over Cu-CHA zeolites : a DFT study

Selective catalytic reduction of nitrogen oxides using ammonia (NH3-SCR) over Cu-exchanged zeolites proceeds via reduction of Cu(ii) to Cu(i) and subsequent reoxidation of Cu(i) to Cu(ii). Although the mechanism of reduction half cycle has been relatively well established, reoxidation pathways of Cu(i) to form the original Cu(ii) species are highly complicated and remain unclear. Herein, oxidation mechanisms of Cu(i) to Cu(ii) species in CHA zeolites during the NH3-SCR process were investigated by periodic DFT calculations. The NH3-solvated Cu(i) and Cu(ii) species were considered for exploring the oxidative activation reaction pathways. The results show that, with O-2 as the sole oxidant, Cu(i) can be effectively oxidized to Cu(ii) via multinuclear Cu-oxo intermediates with moderate reaction barriers. The NO-assisted oxidation of Cu(i) was found to favor the formation of Cu nitrate/nitrite species, which seem to only act as off-cycle resting states. We propose that reoxidation of Cu(i) to Cu(ii) with O-2 as the sole oxidant plays a key role in the oxidation half cycle under standard NH3-SCR conditions

Surface activation by electron scavenger metal nanorod adsorption on TiH2, TiC, TiN, and Ti2O3

Metal/oxide support perimeter sites are known to provide unique properties because the nearby metal changes the local environment on the support surface. In particular, the electron scavenger effect reduces the energy necessary for surface anion desorption, and thereby contributes to activation of the (reverse) Mars-van Krevelen mechanism. This study investigated the possibility of such activation in hydrides, carbides, nitrides, and sulfides. The work functions (WFs) of known hydrides, carbides, nitrides, oxides, and sulfides with group 3, 4, or 5 cations (Sc, Y, La, Ti, Zr, Hf, V, Nb, and Ta) were calculated. The WFs of most hydrides, carbides, and nitrides are smaller than the WF of Ag, implying that the electron scavenger effect may occur when late transition metal nanoparticles are adsorbed on the surface. The WF of oxides and sulfides decreases when reduced. The surface anion vacancy formation energy correlates well with the bulk formation energy in carbides and nitrides, while almost no correlation is found in hydrides because of the small range of surface hydrogen vacancy formation energy values. The electron scavenger effect is explicitly observed in nanorods adsorbed on TiH2 and Ti2O3; the surface vacancy formation energy decreases at anion sites near the nanorod, and charge transfer to the nanorod happens when an anion is removed at such sites. Activation of hydrides, carbides, and nitrides by nanorod adsorption and screening support materials through WF calculation are expected to open up a new category of supported catalysts

High-loading Ga-exchanged MFI zeolites as selective and coke-resistant catalysts for nonoxidative ethane dehydrogenation

In this paper, we investigated the effects of the Ga loading amount and H-2 treatment temperature for the reductive solid-state ion-exchange reaction on the generated Ga species in Ga-exchanged MFI zeolites (Ga-MFIs) as well as their catalysis for ethane dehydrogenation (EDH). For the formation of isolated Ga hydrides in the zeolites, [GaH](2+) ions were preferentially formed in the low-loading Ga-MFI (Ga/Al = 0.3) treated with H-2 at 550 degrees C, corresponding to the conventional preparation conditions, (Ga-MFI-0.3(550)), while the high Ga loading (Ga/Al = 1.0) and high-temperature H-2 treatment (800 degrees C) (Ga-MFI-1.0(800)) induced the formation of [GaH2](+) ions as the major Ga hydrides, as revealed by in situ Fourier transform infrared spectroscopy including the isotope experiment using D-2. In the context of other Ga species, such as Ga+ cations and partially reduced Ga oxides (GaOX), Ga+ cations and GaOX coexist in Ga-MFI-0.3(550), as indicated by pyridine adsorption experiments. On the other hand, GaOX was hardly observed and a larger amount of Ga+ cations was formed in Ga-MFI-1.0(800). The remaining Bronsted acid sites (BASs) were also characterized by the NH3 adsorption experiment. In the EDH reaction, Ga-MFI-1.0(800) exhibited high selectivity owing to low coke formation, resulting in the highest durability among the series of Ga-MFIs tested. Under the optimized conditions, Ga-MFI-1.0(800) exhibited the highest C2H4 formation rate among previously reported Pt-free catalysts. Based on the combined results of characterization, catalyst tests, and kinetic studies, the high selectivity and durability of Ga-MFI-1.0(800) can be ascribed to the low amount of the remaining BASs by isolated Ga species ([GaH](2+), [GaH2](+) ions and Ga+ cations) as well as the major formation of [GaH2](+) ions among isolated Ga hydrides

Forming and quenching behaviours in hot stamping of thin quenchable sheets

A thin aluminium-coated quenchable steel sheet was hot-stamped to investigate the effect of the thickness. The sheets having 0.6, 1.0 and 1.6 mm in thickness were heated at 900 ∘C by a furnace and formed after 7 s from the furnace. The cooling rates of 0.6 mm and 1.0 mm in thickness from 900 ∘C to 400 ∘C under air cooling were 20.9 ∘C/s and 13.6 ∘C/s, respectively. The hardness of the air-cooled sheets having 1.0 mm in thickness was 300 HV1, whereas that of the sheet having 0.6 mm in thickness was 380 HV1 because of the high cooling rate. The Vickers hardness of the U-bent sheets of 0.6 and 1.0 mm after 7 s from the furnace without the holding time at the bottom dead centre were 500 and 430 HV1, respectively

Hot gas bulging of sealed aluminium alloy tube using resistance heating

A hot gas bulging process of a sealed aluminium alloy tube using resistance heating was developed to simplify a control scheme in gas forming. The tube is bulged by the decrease in flow stress of the tube and the increase in internal pressure of compressed air during resistance heating. Hot gas bulging of the sealed aluminium alloy tube without and with axial feeding was performed. The effects of the initial internal pressure and the current density on the expansion ratio of the tube were examined. The decrease in temperature around the contact with the electrode was prevented by inserting a stainless steel ring having low thermal conductivity and high heat generation between the copper electrode and tube, and thus the bulging length was increased. It was found that the amount of bulging can be controlled for the sealed tube by heating without control of internal pressure during forming